Dusan Backovic

Differences in substance use patterns among youths living in foster care institutions and in birth families

Aim: The aim of this study was to determine differences in psychosocial context of occurrence of cigarette smoking and alcohol and drugs use between adolescents living in foster homes and those living with parents. Methods: The study examined 58 adolescents (14–17 years) living in foster homes and 245 living with parents using an anonymous questionnaire. Findings: Consumption of tobacco and cannabis was more common in the group of children living in foster homes. They tried these substances earlier and used them more frequently. The most important predictor for current smoking was the number of peers who smoked. Another important predictor of current smoking was an expressed feeling of loneliness. The studied groups did not differ significantly in the occurrence of alcohol drinking. Conclusions: These results suggest that suitable prevention programmes with emphases on social groups living under adverse conditions are needed. Further research should be conducted to give more detailed insight into the reasons and psychosocial factors that precipitate the start and perpetuation of these habits in diverse environments.

Environmental factors, health-related habits, and serum selenium levels in cancer patients and healthy controls.

Previous studies conducted in Yugoslavia indicated that the concentration of selenium in soil, food items, and serum of the population is very low. The aim of the study was to investigate the possible relationship among environmental, health-related habits, nutrition, and selenium serum levels in cancer patients and the healthy population.The case-control study included a group of cancer patients and a matched group of healthy controls: 57 cancer patients and 41 healthy controls living in Stari Grad (an urban area of Belgrade), as well as 17 cancer patients and 13 healthy controls living in Barajevo (a rural community in the vicinity of Belgrade). The healthy controls were matched to cancer patients in sex and age; they were not blood related.The selenium serum levels were measured by atomic absorption spectrophotometry. Health-related habits and relevant dietary factors (“food frequency” method) that may influence the selenium serum levels were assessed by questionnaires.The differences in average values of selenium serum levels between the cancer patients and healthy controls were not significantly different, but both were below the lowest recorded in referential studies. A significant difference between the values obtained from urban and rural subgroups was noted.The most important factors that influenced the level of selenium included the residence place in the region with selenium deficiency (Barajevo), age, associated chronic diseases, and some dietary factors potentially related to the intake of selenium. The results obtained in this investigation pointed out that use of selenium supplementation in this area should be seriously considered.

Health status of adolescents deprived of parental care

INTRODUCTION Children deprived of parental care are a vulnerahle population with complex needs and health problems. The aim of our study was to assess health status of this population and compare it with children living in their biological families. MATERIAL AND METHODS Our study included 41 adolescents living in foster families (22 boys and 19 girls, mean age 14.66 + 1.39 and 43 adolescents living in child foster homes (16 boys and 27 girls, mean age 14.99 +/- 1.3). The control group consisted of their classmates living with their biological families (45 adolescents, 20 boys and 25 girls, mean age 14.69 +/- 1.43). Health status was assessed by analyzing their medical records. Results There were no differences in regard to anthropometric characteristics (body weight, body height, body mass index) and prevalence of body deformities in studied groups. Acute bronchitis was significantly more fequent in children living in foster families (41.5%) than in other two groups (16.3%--foster homes: 17.8%--biological families). Headaches were significantly more common in groups living in foster families (31.70%) and foster homes (25.6%) than in children living with their biological families. The same was established for myopia (46.3% foster families: 32.6%--foster homes; 1 7.8%--biological families). CONCLUSION Even though there were no differences in regard to characteristics which are indicators of general health, it is apparent that children deprived of parental care present with particularities of health status. Additional researches are necessary in order to get insight into the causality of these phenomena.

Tinnitus among Serbian secondary school students in relation to their behavior and habits

Although tinnitus is a very common symptom, risk factors related to behavior and habits have not been sufficiently investigated. As no investigation on this problem has been performed in Serbia, the aim of our study was to establish the prevalence of tinnitus among Serbian adolescents and to investigate the relationship between their behavior and habits and tinnitus. This investigation was designed as a cross-sectional interview study among secondary school students in Belgrade, Serbia (277 boys and 494 girls). An anonymous questionnaire was self-administered at classes. The investigated variables were: The presence of tinnitus, sources of noise, night outs at noisy places, use of personal music players, smoking, second hand smoke (SHS), substance abuse, coffee and alcohol consumption. Spearmans rank-order correlations and multiple logistic regressions were performed with variables related to behavior and habits as independent ones and tinnitus as a dichotomized dependent variable. Tinnitus was reported by 99 students (12.8%), more frequently among girls compared with boys (P = 0.009). Multivariate logistic regression analysis in boys revealed a significant independent effect of a regular drug abuse on the onset of tinnitus. The chances of tinnitus were 13 times higher among drug addicts compared with non-drug users (odds ratio [OR] and 95% confidence interval [CI] for tinnitus = 13.072; 1.335-127.946). In girls, the significant independent effect on tinnitus was found for daily duration of exposure to SHS (OR and 95% CI for tinnitus = 1.328; 1.073-1.644 /per 2 hours of exposure/).

Factors mediating the depression in the adult obese outpatients

INTRODUCTION The prevalence of obesity is rising to epidemic proportions at the alarming rate in both developed and underdeveloped countries around the world. Current prevalence data from individual national studies suggest that the obesity prevalence in the European countries ranges from 10% to 20% for men, and 10% to 25% for women. Health consequences of obesity imply both a number of fatal and non-fatal health problems (out of which the most common are cardiovascular problems, non-insulin dependent diabetes mellitus, cancers), and also a wide spectrum of psychological consequences from diminished self-esteem to clinical depression. Causal relationship between obesity and many chronic diseases is evidence-based. At the same time, there are marked differences in research data regarding causal obesity-depression relationship. Several studies have found no direct association between obesity and depression, while in others the prevalence of depression in obese patients was up to 50%. Gender, obesity grade, socioeconomic status and asking for professional help are named as moderators and mediators of this relationship. Among recommended screening methods, BDI-II is the most frequently used in the adult outpatient departments. OBJECTIVE The aim of the study was to determine possible risk factors of depression in adult obese patients treated for obesity. Gender, obesity and education level as well as marital status were analyzed as possible moderators of depression-obesity relationship. METHOD The research included 267 patients, 38.0 +/- 14.6 years of age, who referred to the Outpatient Nutrition Department for dietetic consultation or nutritional medical therapy. Nutritional status was assessed by BMI (kg/m2), calculated from measured values of body weight and height according to WHO recommendations. An estimate of the existence and/or depression level was investigated by Beck Depression Inventory--self-administered questionnaire recommended for use in Serbian population. RESULTS The results revealed higher average BDI score values in obese patients (F(267,1) = 6.014, p = 0.015) in comparison to their non-obese counterparts. In addition, the percentage of depressive obese patients was significantly higher (55.1%, chi2(267.1) = 22.64, p < 0.001). There was significant correlation of BMI and BDI scores (r = 0.246, p < 0.001). The number of women with depression was significantly higher in comparison to men (chi2(267.1) = 4.261, p = 0.039). Women also had higher average BDI score (p = 0.003). MANOVA showed that BDI score was influenced by gender (F(267.1) = 8.936, p = 0.030) and nutritional status (F(267.1) = 6.115, p = 0.014), but combined effect of the above-mentioned moderators was not significant. CONCLUSION Depression is ten times more frequent in obese patients undergoing the obesity treatment vs. general population and, therefore, screening for depression is needed. Special attention should be paid to women and more obese patients due to higher incidence of depression in these groups.

Knowledge and attitudes on medical waste management among Belgrade medical and dental students

Online first: October 16, 2018 SUMMARY Introduction/Objective Knowledge and practical skills in medical waste (MW) management are of equal importance for medical and dental doctors. The first comparative study on the knowledge and skills in the field of MW management among Belgrade students was conducted with the goal of examining whether students of medicine and dentistry are equally familiar with this extremely important field. Methods A cross-sectional study included 558 students of the sixth year of studies (430 medical and 128 dental students) who completed an anonymous semi-structured questionnaire to determine attitudes and knowledge on MW management. Results The majority of medical and dental students had no training in MW management (79.5% and 74.6%, respectively). Dental students use protective equipment more frequently than medical students (94.5% vs. 42%, p < 0.001). However, full vaccinal protection against hepatitis B is better among medical students compared to dental students (57.7% vs. 39.1%, p < 0.001). Complete knowledge on postexposal prophylaxis is better among medical students compared to dental students (44.5% vs. 13.3%, p < 0.001). However, dental students are more disciplined in reporting injuries (63.1% vs. 52.4%, p = 0.038). The students’ knowledge on primary separation of infectious waste (93% vs. 77.8%, p < 0.001) and used needles (80.3% vs. 70.4%, p = 0.007) is better among dental students compared to medical students’ correct answers. Conclusion Dental students show better knowledge on MW management and are more disciplined in using personal infection protection compared to medical students. The students support continued training on MW management and investigations on this topic.

Burnout syndrome as a mental health problem among medical students

Introduction. Mental health problems of adolescents are among the prevailing problems of public health. While studying for their future medical profession, the students of medicine have to exchange emotions with the patients intensively, and the empathic relationship itself bears a risk of eventual ”emotional depletion”, which leads to ”professional lack of emotions”. The study was aimed at presenting burnout syndrome as a challenge for mental health of medical students, its importance for the future professional engagement of doctors and the possibilities of its prevention. Methods. The authors of this paper review and analyze data and conclusions of previous national and international studies from this field and suggest possibilities of overcoming the condition of burnout. Results. The frequency of burnout syndrome, which is the synonym for the above mentioned condition of emotional exhaustion, is twice as high in medical professionals, particularly young ones, as in other professions on average. Burnout syndrome is nowadays regarded as a psychological distress experienced during the educational process and it has been observed in as many as 50% of medical students. The most significant factors independently associated with student burnout are: personality traits, stressful personal life events and learning and training conditions at their faculties. Conclusions. It is of utmost importance to understand the causes and consequences of psychological distress in students, and the faculties should not only identify these problems, but also endeavor to promote health by developing strategies for improving personal well-being, which are important for future doctors to achieve professional success and develop resistance to stress.